These are great times in which to be a pregnant lady. We have a greater degree of choice than any pregnant ladies who have come before us. We have simultaneously the most advanced allopathic medical care that has yet been devised, and also growing support for complementary homeopathic and alternative health care approaches.
We no longer have to squat in a field unless we choose to. The whole concept of a woman's right to choose how she gives birth is historically groundbreaking. And today expectant mothers face an embarrassment of choice.
So much choice, in fact, that the burden of power may have shifted unduly in a way that warps our understanding of what is ours to choose and what is not.
When I was pregnant I had a stack of pregnancy books, and every one of them carried on at great length at how important it was to make a five-page birth plan, and to bring an Indian bedspread and amethyst crystals and incense and your favourite Enya cd to the hospital, if you insisted on going to the hospital, but all the cool moms were birthing at home in pools with doulas and midwives...and so on.
I wish even one of those books had spent a less time pressuring me to create elaborate castles in the air and had instead taken a single minute to say, “hey: you can choose some of this, but some of this is not up to you.
Consider what choices are important to you now, and take the time to prioritize them so you know what matters to you, but understand that when the birth happens, reality might vary from your plan, and what matters most is that your baby and you are healthy and safe.”
I support every woman's right to make her own decisions about her body, her health care, and what she feels is right for her new family. That said, I feel a social responsibility to encourage women to balance their personal preferences with an acknowledgement that having a baby is serious business that involves more than one life and that things don't always go according to plan.
I suggest that you keep an open mind and try to balance your choices for what you want to happen with an acceptance of the unknowable, in the interest of the healthiest and safest possible outcome.
So how did we get where we are, in this modern-day cornucopia of birth choices and practices?
7 Water Birth
People have been having water births for at least eight thousand years. There are Egyptian petroglyphs of pharaohs being born this way. Minoan women gave birth in water birth temples. Ancient Japanese islanders, the Maori, and native Californians also water birthed. In fact throughout the ancient world, where there was water, women were water birthing.
But when modern medicine arrived, this traditional practice disappeared. It was rediscovered in France in 1803 when, after a prolonged labor, a doctor put a woman in a warm bath. The idea disappeared again until the 1960s and '70s, when the Soviets and the French were researching how to make birth less traumatic for everyone.
Australian midwives also introduced the idea for home births. Water births arrived in America in the '80s and were catching on by the '90s. Today they are an accepted option.
Water births are soothing and reduce stress hormones and emotional trauma for mother and baby. They also reduce pain and tearing. This calmer experience also reduces the need for medication, for C-sections, and for medical intervention.
Check with your doctor about the contraindications and with your hospital to see what their water birth options are. Tubs are also available for rent if you want to give birth at home. If you do choose to give birth at home, please do so with medical professionals and their equipment at the ready!
6 Home Birth
My mother had my sister at home. “At home” was historically the only choice for a long time (unless you had a Minoan water birthing temple handy). Childbirth in familiar surroundings provides emotional security in a vulnerable time. Less stress leads to fewer stress hormones coursing through the body, which makes a more pleasant experience for mother and baby alike.
However, although home is cozier than a hospital, it doesn't have a team of anaesthesiologists, surgeons, radiologists, and expensive equipment standing by just-in-case. If you want to have your baby at home, I suggest you discuss this choice with your doctor beforehand.
If you're going to do it this way, don't be home alone like Scarlett O'Hara, with no company except Butterfly McQueen saying, “I don't know nothin' 'bout birthin' babies!” Make sure you have your pre-established retinue of medical professionals ready. Find out beforehand how they handle emergencies.
5 Midwives And Doulas
Wise women have been helping other women have babies forever. Today's midwife has a limited medical practice and is certified to deliver babies and to dispense a small range of medicines, and has more of a normalizing (and less of a pathologizing) ideological approach than an MD.
A doula is more like a coach, who creates a supportive bond with the mother before the birthday, answers her questions, and provides emotional support through and after the birth. Both women do their jobs in hospitals, clinics, birthing centers, and private homes.
Out here in the colonies, childbirth was originally dealt with by midwives. These women acquired their knowledge first-hand, from those who had mastered the skills before them. Not out of books. So they were considered “untrained,” and in the 19th century, men made occasional ill-fated attempts to make official training programs for midwives.
Also in the 19th century, medical licensing, insurance, and specialization codified doctoring, nudging midwives and their folk-craft ways to the side. By the turn of the century, hospitals became part of the ordinary world, men understood the profitability of surgery, rich women had their babies in hospitals, and midwives were for the poor.
In the '50s and '60s, nurse-midwifery began to be organized and officially trained in schools. The practice gathered credibility, and today, we're almost up to where we were four hundred years ago in respect for the profession!
But there are still places where direct-entry midwifery is illegal, and qualification requirements vary from place to place. So if you're considering using a midwife, as with any medical professional, get to know her credentials before committing.
Women started giving birth in hospitals when anaesthesia became an option. In the late 1800's, a combination of morphine and scopolamine called“Twilight Sleep” put women out of pain and made them forget the experience of childbirth. It arrived in the US in 1914 and originally was only available for rich women.
By 1938 it was used in every hospital delivery, thanks to the concerted efforts of women who campaigned for ordinary women to have the option. My grandmother was a typical white-collar Mad Men-era housewife, and when it was time to have her babies, they sedated her through the births and then she woke up next to the next Bundle of Joy.
However, sleepy women aren't active. They're not good at communicating, or at pushing, thus necessitating more forceps and C-sections. The babies come out sleepy, disinclined to breathe, and often in need of resuscitation.
Spinal anaesthesia, which had been around for non-pregnancy purposes since the turn of the century, was a localized solution and was improved mid-century. The spinal block took away the pain and sleepiness, but women still couldn't push.
The epidural, first used in the 1940s, delivers a steady stoppable stream of medicine, unlike the spinal block which offers one dose of medicine that lasts for a set amount of time. This means with an epidural, women are available to push when needed. Epidurals or anaesthetic combinations are becoming the norm in wealthy countries because they offer flexibility and control.
After women's rights activists fought hard for a woman's right to anaesthesia, the Women's Lib Movement fought just as hard for a woman’s right to no anaesthesia! The Women's Libbers saw natural childbirth as a way of sticking it to the Man. By having women step away from sedation, they believed they were taking power away from the (usually male) doctors and giving it back to the women having babies.
The move for natural childbirth, from mid-century onward, normalizes the experience and empowers women. The Lamaze philosophy is a popular element of natural childbirth. Lamaze prioritizes education, relaxation, deep breathing, and emotional support.
Dr. Lamaze introduced it in France in 1951 after observing techniques in Russia, and it made its way to America. Today its principles include movement, following your urges, having a loved one nearby, and avoiding unnecessary medical intervention. Lamaze empowers women to make and trust their own choices.
2 Birthing Centers
Birthing centers are rising in popularity. They're run by midwives, emphasize that birth is a natural process, and minimize medical intervention. They send you home promptly and are homey, with real beds and cozy décor. You can eat and drink, have a shower or a whirlpool, and visit with your family.
If yours is a low-risk pregnancy and this is an appropriate choice, you can enjoy this snuggly and less expensive experience, with some but not all medicines available. For instance, you can have narcotics but not an epidural (for which you would be transferred to a hospital).
And a study of Amish birth centers found that part of why they have a lower C-section rate than hospitals is because doctors at these centers turn breech babies from the outside, instead of automatically opting for a C-section.
Birth centers started in the 1970s as a reaction to institutionalized and scissor-happy hospital care. Originally popular with poor and isolated women, they're coming into their own with all social demographics. Some Australian birth centers in are moving toward accepting women with known medical complications and providing them with extra care.
1 Elective C-Sections
We are only discussing this unfortunate growing trend so you understand what other women are doing. I had an emergency C-section. C-sections are powerful surgery that saves lives, but they change your life in ways that are only desirable if you have no other option.
Proponents (whom I view as misguided) choose them for perceived convenience, perceived avoidance of pain and tearing, and avoidance of the risk of later incontinence and sexual dysfunction.
Some women ask for planned C-sections so they can put the day on their calendars and plan their maternity leave and child-care needs. But babies don't care about schedules. And by voluntarily turning yourself into a major surgery patient, you're complicating your maternity leave and child-care needs in unforeseeable ways.
As far as pain and tearing go: the pain of a vaginal birth subsides months before that of a C-section, and tearing is easier on the body than having your major supporting muscles severed. And while C-section ladies don't have their vaginas stretched out by baby heads, it's a tiny consolation prize.